TY - JOUR
T1 - Predictive value of pretreatment metabolic activity measured by fluorodeoxyglucose positron emission tomography in patients with metastatic advanced gastric cancer
T2 - The maximal SUV of the stomach is a prognostic factor
AU - Park, Jun Chul
AU - Lee, Jae Hoon
AU - Cheoi, Kungseok
AU - Chung, Hyunsoo
AU - Yun, Mi Jin
AU - Lee, Hyuk
AU - Shin, Sung Kwan
AU - Lee, Sang Kil
AU - Lee, Yong Chan
PY - 2012/7
Y1 - 2012/7
N2 - Purpose: Few studies have evaluated metabolic activity by 18F-FDG PET as a prognostic factor in advanced gastric cancer (AGC). We investigated its prognostic role in metastatic AGC. Methods: We enrolled 82 patients with metastatic AGC, who were treatment-naive and underwent pretreatment 18F-FDG PET/CT scanning. In each patient, the maximal standardized uptake value (SUVmax) was measured in each target lesion. StomachSUVmax was defined as SUVmax in the stomach, while Total SUVmax was defined as the highest SUVmax among all the target lesions. Results: The stomach was the organ most frequently displaying the highest SUVmax among all the target lesions (in 67.1 % of patients). A TotalSUVmax value of 11.5 was the value with the maximum sum of sensitivity and specificity from receiver-operating characteristic curves for progression-free survival (PFS). PFS was significantly longer in patients with a TotalSUVmax value <11.5 than in those with a Total SUVmax value ≥11.5 (P=0.023); however, overall survival (OS) was not (P=0.055). A StomachSUVmax value of 6.0 was derived by similar methods. PFS and OS were significantly longer in those with a Stomach SUVmax value <6.0 than in those with a StomachSUVmax value ≥6.0 (P=0.001 and P=0.006, respectively). Furthermore, those with a low TotalSUVmax and those with a low StomachSUVmax showed better chemotherapeutic responses (P=0.016 and P=0.034, respectively). Among patients with histologically undifferentiated carcinomas, those with lower TotalSUVmax and those with lower StomachSUVmax showed longer median PFS (P=0.027 and P=0.005, respectively) and OS (P=0.009 and P <0.001, respectively). Multivariate analysis demonstrated Stomach SUVmax as an independent predictor of PFS (P=0.002) and OS (P=0.038). Conclusion: Pretreatment metabolic activity may be a useful prognostic marker in patients with metastatic AGC undergoing palliative chemotherapy. Notably, StomachSUVmax was the single, most robust factor predicting prognosis.
AB - Purpose: Few studies have evaluated metabolic activity by 18F-FDG PET as a prognostic factor in advanced gastric cancer (AGC). We investigated its prognostic role in metastatic AGC. Methods: We enrolled 82 patients with metastatic AGC, who were treatment-naive and underwent pretreatment 18F-FDG PET/CT scanning. In each patient, the maximal standardized uptake value (SUVmax) was measured in each target lesion. StomachSUVmax was defined as SUVmax in the stomach, while Total SUVmax was defined as the highest SUVmax among all the target lesions. Results: The stomach was the organ most frequently displaying the highest SUVmax among all the target lesions (in 67.1 % of patients). A TotalSUVmax value of 11.5 was the value with the maximum sum of sensitivity and specificity from receiver-operating characteristic curves for progression-free survival (PFS). PFS was significantly longer in patients with a TotalSUVmax value <11.5 than in those with a Total SUVmax value ≥11.5 (P=0.023); however, overall survival (OS) was not (P=0.055). A StomachSUVmax value of 6.0 was derived by similar methods. PFS and OS were significantly longer in those with a Stomach SUVmax value <6.0 than in those with a StomachSUVmax value ≥6.0 (P=0.001 and P=0.006, respectively). Furthermore, those with a low TotalSUVmax and those with a low StomachSUVmax showed better chemotherapeutic responses (P=0.016 and P=0.034, respectively). Among patients with histologically undifferentiated carcinomas, those with lower TotalSUVmax and those with lower StomachSUVmax showed longer median PFS (P=0.027 and P=0.005, respectively) and OS (P=0.009 and P <0.001, respectively). Multivariate analysis demonstrated Stomach SUVmax as an independent predictor of PFS (P=0.002) and OS (P=0.038). Conclusion: Pretreatment metabolic activity may be a useful prognostic marker in patients with metastatic AGC undergoing palliative chemotherapy. Notably, StomachSUVmax was the single, most robust factor predicting prognosis.
KW - Advanced gastric cancer
KW - Chemotherapeutic response
KW - Maximal SUV
KW - Pretreatment fluorodeoxyglucose uptake
KW - Prognosis
UR - https://www.scopus.com/pages/publications/84862699614
U2 - 10.1007/s00259-012-2116-x
DO - 10.1007/s00259-012-2116-x
M3 - Article
C2 - 22526958
AN - SCOPUS:84862699614
SN - 1619-7070
VL - 39
SP - 1107
EP - 1116
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 7
ER -
